OECD Ülkelerinde Uzun Dönemli Bakım Hizmetlerinin Etkinliğinin Değerlendirilmesi

Doğumda beklenen yaşam süresinin artması ve doğurganlık hızının azalması sonucu ülkelerin yaşlınüfus oranları artmaktadır. Kronik ve mental rahatsızlıklardan kaynaklı olarak yaşlılar uzun dönemlibakım hizmetlerinden daha fazla faydalanmaktadır. Yaşlı bireylerin uzun dönemli bakım hizmetlerikullanımının artması uzun dönemli bakımda etkinlik konusunda çalışmalar yapılmasını zorunlukılmaktadır. Bu çalışmada, seçilmiş OECD ülkelerinin uzun dönemli bakım hizmetleri etkinlikdüzeyleri 2015, 2016 ve 2017 yılları bazında Veri Zarflama Analizi (VZA), Malmquist ToplamFaktör Verimliliği Endeksi (MTFV) ve Tobit regresyon analizleri ile incelenmiş, etkinliğe etki edendeğişkenler ortaya konmuş ve etkinlik ile ilgili sorun yaşayan ülkeler için önerilerde bulunulmuştur.

Assessing the Efficiency of Long-Term Care Services in OECD Countries

As the life expectancy at birth increases and the fertility rate decreases, the elderly population rates of countries increase. Elderly people more benefit from long-term care services due to chronic and mental disorders. Increasing use of long-term care services by elderly individuals necessitates studies on efficiency in long-term care. In this study, the efficiency levels of long-term care services of selected OECD countries were analyzed by Data Envelopment Analysis (DEA), Malmquist Total Factor Productivity Index (MTFP) and Tobit regression analyzes on the basis of 2015, 2016 and 2017. Variables affecting efficiency have been put forward and recommendations have been made for the countries that have problems with efficiency.

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Abbasi, F., & Hajihoseini H. (2004). Technological efficiency of R&D units. In A. Emrouznejad & V. Podinovski (Ed.), Data envelopment analysis and performance management. UK: Warwick Print.
Abdel-Rahman, N., Yoffe, N., Siman-Tov, M., Radovmislensky, I., & Peleg, K. (2019). Achieving ethnic equality in the Israel trauma healthcare system: the case of the elderly population. Israel Journal of Health Policy Research, 8(1), 25.
Alamgir, H., Yu, S., Fast, C., Hennessy, S., Kidd, C., & Yassi, A. (2008). Efficiency of overhead ceiling lifts in reducing musculoskeletal injury among carers working in long-term care institutions. Injury, 39(5), 570-577.
Anderson, G. F., & Hussey, P. S. (2000). Population Aging: A Comparison Among Industrialized Countries: Populations around the world are growing older, but the trends are not cause for despair. Health Affairs, 19(3), 191-203.
Ayanoğlu, Y., Atan, M. & Beylik, U. (2010). Hastanelerde veri zarflama analizi (VZA) yöntemiyle finansal performans ölçümü ve değerlendirilmesi. Sağlıkta Performans ve Kalite Dergisi, 2(2), 40-62.
Banker, R. D., Charnes, A., & Cooper, W. W. (1984). Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis. Management Science, 30(9), 1078-1092.
Berta, W., Laporte, A., & Kachan, N. (2010). Unpacking the relationship between operational efficiency and quality of care in Ontario long-term care homes. Canadian Journal on Aging/La Revue canadienne du vieillissement, 29(4), 543-556.
Björkgren, M. A., Häkkinen, U., & Linna, M. (2001). Measuring efficiency of long-term care units in Finland. Health Care Management Science, 4(3), 193- 200.
Boles, J.S., Donthu N., & Lohtia R. (1995). Salesperson Evaluation Using Relative Performance Efficiency: The Application of Data Envelopment Analysis. Journal of Personal Selling and Sales Management, 15(3), 31-49.
Caves, D. W., Christensen, L. R., & Diewert, W. E. (1982a). The Economic Theory of Index Numbers and the Measuremnt of Input, Output, and Productivity. Econometrica, 50, 1393-1414.
Caves, D. W., Christensen, L. R., & Diewert, W. E. (1982b). Multilateral Comparisons of Output, Input, and Productivity Using Superlative Index Numbers. The Economic Journal, 92, 73-86.
Charnes, A., Cooper, W., & Rhodes, E. (1978). Measuring the Efficiency of Decision Making. European Journal of Operational Research, 2(6), 429–444.
Chern, J.Y., & Wan T.T. (2000). The Iimpact of the Prospective Payment System on the Technical Efficiency of Hospitals. Journal of Medical Systems, 24, 159–172.
Chowdhury, H., Wodchis, W., & Laporte, A. (2011). Efficiency and Technological Change in Health Care Services in Ontario: An Application of Malmquist Productivity Index with Bootstrapping. International Journal of Productivity and Performance Management, 60(7), 721–745.
Colombo, F., Llena-Nozal A., Mercier J., & Tjadens F. (2011). Help Wanted?: Providing and Paying for LongTerm Care. Paris: OECD Publishing.
Deviren N.V., & Duran T. (2018). Türkiye’de düzey 3 bölgesi kamu yatırımları etkinliğinin veri zarflama analizi (VZA) yöntemiyle ölçülmesi: Aydın, Denizli VE Muğla illeri örneği. Elektronik Sosyal Bilimler Dergisi, 17(65), 262-277.
Grifell-Tatje, E., & Lovell, C. A. K. (1996). Deregulation and Productivity Decline: The Case of Spanish Savings Banks. European Economic Review, 40(6), 1281-1303.
Harris, J.M., Ozgen H., & Ozcan Y.A. (2000). Do Mergers Enhance the Performance of Hospital Efficiency?. Journal of Operations Research Society, 51, 801–811.
Hoff, A. (2006). Bootstrapping Malmquist Indices for Danish Seiners in the North Sea and Skagerrak. Journal of Applied Statistics, 33(9), 891-907.
Ingle, G. K., & Nath, A. (2008). Geriatric health in India: Concerns and solutions. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 33(4), 214.
İnterRAI. (2019). Case-Mix Classification. (Erişim: 06/08/2019), https://www.interrai.org/classification.html
Koç Ş., & Şahin M. (2018). Tobit model ve bir uygulama. KSÜ Doğa Bilimleri Dergisi, 21(1), 73-80.
Laine, J., Linna, M., Häkkinen, U., & Noro, A. (2005). Measuring the productive efficiency and clinical quality of institutional long‐term care for the elderly. Health Economics, 14(3), 245-256.
LaPlante, A.E. & Paradi J.C. (2015). Evaluation of Bank Branch Growth Potential Using Data Envelopment Analysis. Omega, 52, 33-41.
Malmquist, S. (1953). Index numbers and indifference surfaces. Trabajos de Estadistica y de Investigacion Operativa, 4(2), 209-242.
Mardini, M. T., Iraqi, Y., & Agoulmine, N. (2019). A Survey of Healthcare Monitoring Systems for Chronically Ill Patients and Elderly. Journal of Medical Systems, 43(3), 50.
Moreno-Serra, R., & Smith, P. (2012). An Exploratory Application of Data Envelopment Analysis to the Efficiency of Health Service Coverage And Access.(Erişim: 05/08/2019), https://www.r4d.org/wpcontent/uploads/THF-Efficiency-of-health-servicecoverage-and-access.pdf
Narcı, H. Ö. (2012). Sağlık Kurumlarında Verimlilik Ölçümü ve Yöntemleri. In İ. Şahin & H.Ö. Narcı (Ed.), Sağlık Kurumlarında Operasyon Yönetimi. Eskişehir: T.C. Anadolu Üniversitesi Yayını.
OECD. (2015). Health at a Glance 2015: OECD Indicators. Paris: OECD Publishing.
OECD. (2017). Health at a Glance 2017: OECD Indicators. Paris: OECD Publishing.
OECD. (2019). Health Data. (Erişim: 07/08/2019), http://www.oecd.org/els/health-systems/healthdata.htm OECD/European Commission. (2013). A Good Life in Old Age? Monitoring and Improving Quality in Long-term Care. OECD Publishing.
Ozbugday, F. C., Tirgil, A., & Kose, E. G. (2019). Efficiency changes in long-term care in OECD countries: A nonparametric Malmquist Index approach. SocioEconomic Planning Sciences.
Özcan, Y. A., & Khushalani, J. (2017). Assessing efficiency of public health and medical care provision in OECD countries after a decade of reform. Central European Journal of Operations Research, 25(2), 325-343.
Özcan, Y.A. (2014). Health Care Benchmarking and Performance Evaluation. USA: Springer. Özgen, H., & Özcan Y.A. (2004). Longitudinal Analysis of Efficiency in Multiple Output Dialysis Markets. Health Care Management Science, 7, 253-261.
Roh, C. Y., Park, C., & Moon, M. J. (2011). Economic Performances of U.S. Non-profit Hospitals Using the Malmquist Productivity Change Index. Journal of Management and Marketing Research, 8(1), 1-16.
Samut, P.K., & Cafri, R. (2016). Analysis of the Efficiency Determinants of Health Systems in OECD Countries by DEA and Panel Tobit. Social Indicators Research, 129, 113-132.
Sarı, Z. (2015). Veri Zarflama Analizi ve Bir Uygulama. Yüksek Lisans Tezi, Hacettepe Üniversitesi Fen Bilimleri Enstitüsü, Ankara.
Sherman, H. D. (1984). Data Envelopment Analysis as a New Manegerial Audit Methodology- Test and Evaluation. Auditing: A Journal of Practice and Theory, 4, 35-53.
Shimizutani, S., & Suzuki, W. (2002). The quality and efficiency of at-home long-term care in Japan: Evidence from micro-level data. Economic and Social Research Institute (ESRI).
Sivakumar, P. T., Mukku, S. S. R., Antony, S., Harbishettar, V., Kumar, C. N., & Math, S. B. (2019). Implications of Mental Healthcare Act 2017 for geriatric mental health care delivery: A critical appraisal. Indian Journal of Psychiatry, 61(4), 763.
Smith, P. C., Mossialos, E., Leatherman, S., & Papanicolas, I. (2009). Performance measurement for health system improvement: experiences, challenges and prospects. Cambridge University Press.
Spillman, B. C., & Lubitz, J. (2000). The effect of longevity on spending for acute and long-term care. New England Journal of Medicine, 342(19), 1409-1415.
Spinks, J. & Hollingsworth, B. (2009). Cross-Country Comparisons of Technical Efficiency of Health Production: A Demonstration of Pitfalls. Applied Economics, 41(4), 417-427.
Şahin, İ. (2008). Sağlık Bakanlığı Genel Hastaneleri ve Sağlık Bakanlığına Devredilen SSK Genel Hastanelerinin Teknik Verimliliklerinin Karşılaştırmalı Analizi. Hacettepe Sağlık İdaresi Dergisi, 11(1), 1-48.
Tobin J. (1958). Estimation of relationships for limited dependent variables. Econometrica, Journal of Econometric Society, 26(1), 24-36.
Vassiloglou, M., & Giokas, D. (1990). A study of the relative efficiency of bank branches: an application of data envelopment analysis. Journal of the Operational Research Society, 41(7), 591-597.
Wichmann, A. B., Adang, E. M., Vissers, K. C., Szczerbińska, K., Kylänen, M., Payne, S., vd. (2018). Technical-efficiency analysis of end-of-life care in long-term care facilities within Europe: A crosssectional study of deceased residents in 6 EU countries (PACE). PloS One, 13(11), 1-12.